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Alzheimer’s disease (AD) is the most prevalent neurodegenerative disease of the brain, which is characterized by a progressive loss of memory and spatial orientation. Only less than 5-10% of AD sufferers are familial cases due to genetic mutations in the amyloid precursor protein (APP) gene or presenilin (PS) 1 and 2 genes. The cause of sporadic AD (sAD) which covers > 95% of AD patients is still unknown. Current research found interactions between aging, diabetes and cognitive decline including dementia in general and in AD in particular. Disturbances of brain glucose uptake, glucose tolerance and utilization and impairment of the insulin/insulin receptor (IR) signaling cascade are thought to be key targets for the development of sAD.
In the brain of AD patients, neural plasticity is impaired indicated by synaptic and neuronal loss. Adult neurogenesis (AN), the generation of functional neurons in the adult brain, may be able to restore neurological function deficits through the integration of newborn neurons into existing neural networks. The dentate gyrus of the hippocampus is one out of few brain regions where life-long AN exists. However, there is a big controversy in literature regarding the involvement of AN in AD pathology. Most animal studies used transgenic mice based on the Amyloid ß (Aß) hypothesis which primarily act as models for the familial form of AD. Findings from human post mortem AN studies were also inconstistent. In this thesis, we focused on the possible involvement of AN in the pathogenesis of the sporadic form of AD. Streptozotocin intracerebroventricularily (STZ icv) treated rats, which develop an insulin-resistant brain state and learning and memory deficits preceding Aß pathology act as an appropriate animal model for sAD. We used STZ treatment for both parts of my work, for the in vivo and in vitro study.
In the first part of my thesis, my coworkers and I investigated STZ icv treatment effects on different stages of AN in an in vivo approach. Even if STZ icv treatment does not seem to considerably influence stem cell proliferation over a short-term (1 month after STZ icv treatment) as well as in a long-term (3 months after STZ icv treatment) period, it results in significantly less immature and newborn mature neurons 3 months after STZ icv treatment. This reduction detected after 3 months was specific for the septal hippocampus, discussed to be important for spatial learning. Subsequently we performed co-localization studies with antibodies detecting BrdU (applied appr. 27 days before sacrifice) and cell-type specific markers such as NeuN, and GFAP, we found that STZ treatment does not affect the differentiation fate of newly generated cells. Phenotype analysis of BrdU-positive cells in the hilus and molecular layer revealed that some of the BrdU-positive cells are newborn oligodendrocytes but not newborn microglia.
In the second part of my thesis I worked with cultured neural stem cells (NSCs) isolated from the adult rat hippocampus to reveal STZ effects on the proliferation of of NSCs, and on the survival and differentiation of their progeny. Furthermore, this in vitro approach enabled me to study cellular mechanisms underlying the observed impaired neurogenesis in the hippocampus of STZ-treated rats. In contrast to our findings of the STZ icv in vivo study we revealed that STZ supplied with the cell culture medium inhibits the proliferation of NSCs in a dose-dependent and time-dependent manner. Moreover, performing immunofluorescence studies with antibodies detecting cell-type specific markers after triggering NSCs to differentiate, we could show that STZ treatment affects the number of newly generated neurons but not of astrocytes. Analyzing newborn cells starting to differentiate and migrate I was able to demonstrate that STZ has no effect on the migration of newborn cells. Trying to reveal cellular mechanisms underlying the negative influence of STZ on hippocampal AN, we performed qRT-PCR and immunofluorescence staining and thus could show that in NSCs the expression of glucose transporter (GLUT)3 mRNA as well as IR and GLUT3 protein levels are reduced after STZ treatment. Therefore, the inhibition of the proliferation of NSCs may be (at least partially) caused by these two molecules. Interestingly, the effect of STZ on differentiating cells was shown to be different, as IR protein expression was not significantly changed but GLUT3 protein levels were decreased in consequence of STZ treatment.
In summary, this project delivered further insights into the interrelation between AN the sporadic form of sAD and thus provides a basis of new therapeutic approaches in sAD treatment through intervening AN. Discrepancies between the results of the two parts of my thesis, the in vivo and in vitro part, were certainly caused to a certain extent by the missing microenvironment in the in vitro approach with cultured NSCs. Future studies e.g. using co-culture systems could at least minimize the effect of a missing natural microenvironment of cultured NSCs, so that the use of an in vitro approach for the investigation of STZ treatment underlying cellular mechanisms can be improved.
Unterschiede in Frontaler Kortex Oxygenierung in zweierlei Risikogruppen der Alzheimer Demenz
(2019)
Die verbesserte medizinische Versorgung führt zu einer zunehmenden Lebenserwartung unserer Gesellschaft. Damit steigt auch die sozioökonomische Relevanz neurodegenerativer Erkrankungen kontinuierlich. Für die Alzheimer Demenz (AD), die dabei die häufigste Ursache darstellt, stehen bisher keine krankheitsmodifizierenden Behandlungsoptionen zur Verfügung. Die lange präklinische Phase der Erkrankung birgt jedoch großes Potential für die Entwicklung neuer Behandlungsoptionen. Das Untersuchen von Risikogruppen ist für die Identifikation von Prädiktoren einer späteren AD Manifestation von besonderem Interesse. In diesem Zusammenhang werden insbesondere das Vorliegen genetischer Risikokonstellationen, wie dem Apolipoprotein E (APOE) Ɛ4-Allel, sowie kognitiver Risikofaktoren, wie der „leichten kognitiven Beeinträchtigung“ (MCI), diskutiert. Die Identifikation präklinischer Aktivierungsunterschiede in relevanten Gehirnregionen von Risikogruppen kann als Basis für die Entwicklung neurofunktioneller Früherkennungs-Marker dienen. Der präfrontale Kortex (PFC), welcher mit der Steuerung von Exekutivfunktionen assoziiert wird, hat sich in diesem Zusammenhang in bisherigen Studien als eine relevante Schlüsselregion manifestiert. Aufgrund der aufwendigen und kostenintensiven bildgebenden Untersuchungsmethoden, sind die genauen Prozesse jedoch noch unklar.
Ziel der vorliegenden Arbeit war es daher, Unterschiede in der PFC Oxygenierung in zweierlei Risikogruppen der AD mit einer kostengünstigeren Bildgebungsmethode, der funktionellen Nahinfrarot Spektroskopie (fNIRS), zu untersuchen. Dafür wurde in einem ersten Schritt, der Trailmaking Test (TMT), ein weitverbreiteter neuropsychologischer Test zur Erfassung exekutiver Funktionen, für fNIRS implementiert. Als Grundlage für die Untersuchung frühpathologischer Prozesse, wurden zunächst gesunde Alterungsprozesse betrachtet. Der Vergleich von jungen und älteren Probanden (n = 20 pro Gruppe) wies neben der Eignung der Testimplementierung für fNIRS auf eine spezifische bilaterale PFC Oxygenierung hin, welche bei jungen Probanden rechtshemisphärisch lateralisiert war. Ältere Probanden hingegen zeigten bei vergleichbaren Verhaltensdaten insgesamt mehr signifikante Kanäle sowie eine Abnahme der Lateralisierung. Dies kann als zusätzlicher Bedarf an Ressourcen in gesunden Alterungsprozessen interpretiert werden.
Im Rahmen der Hauptstudie wurden anschließend insgesamt 604 ältere Probanden im Alter von 70 bis 76 Jahren untersucht. Zunächst wurde die genetische Risikogruppe der Ɛ4-Allel-Träger (n = 78) mit den neutralen Ɛ3-Allel-Trägern (n = 216) und den Trägern des als protektiv geltenden Ɛ2-Allels (n = 50) verglichen. Hierbei zeigte sich eine geringere Oxygenierung der Risikogruppe bei geringer Aufgabenschwierigkeit, während sich ein erhöhter Oxygenierungsanstieg im medialen PFC mit steigender Aufgabenschwierigkeit zeigte. Dies deutet auf einen erhöhten Bedarf an neuronalen Kontrollmechanismen der Risikogruppe zur Bewältigung der steigenden Aufgabenschwierigkeit hin. Die protektive Gruppe zeigte hingegen eine erhöhte Oxygenierung im ventralen PFC mit steigender Aufgabenschwierigkeit, was möglicherweise auf einen präventiven Effekt hindeuten könnte.
Weiterführend wurden MCI-Patienten mit gesunden Probanden (n = 57 pro Gruppe) hinsichtlich des kognitiven Risikofaktors verglichen. Hierbei zeigte sich ein punktuell reduzierter Oxygenierunganstieg der MCI Patienten mit steigender Aufgabenschwierigkeit vor allem im ventralen PFC bei ebenfalls stabiler Verhaltensleistung. Die gefundene Reduktion könnte ein Zeichen für eine aufgebrauchte kognitive Reserve sein, welche Einbußen auf Verhaltensebene voranzugehen scheint.
Diese charakteristischen Unterschiede in den frontalen Oxygenierungsmustern von Risikogruppen (APOE, MCI) könnten als Biomarker zur Früherkennung von AD noch vor dem Auftreten kognitiver Einbußen dienen. Die fNIRS-Untersuchung während der Durchführung des TMT hat sich in diesem Zusammenhang als potentielles Instrument zur Frühdiagnose der präklinischen Phase der AD als geeignet erwiesen. Die Ergebnisse werden unter Einbezug des wissenschaftlichen Kontexts interpretiert und Implikationen für weitere notwendige Studien sowie die klinische Anwendbarkeit diskutiert.
Jeder Zwanzigste im Alter von über 60 Jahren ist von einer Demenzerkrankung betroffen. Mit zunehmendem Alter steigt der Anteil Betroffener drastisch. Hierbei ist die Alzheimer-Demenz (AD) der häufigste Subtyp der Demenzerkrankungen. Symptomatisch ist diese Erkrankung vorwiegend charakterisiert durch ein Nachlassen der Gedächtnisfunktionen; neuropathologisch weisen Patienten mit AD neurofibrilläre Bündel von Tau-Protein-Ablagerungen, Amyloid-β (Aβ) Plaques sowie einen verringerten zerebralen Blutfluss auf.
Aktuell gibt es noch keine Behandlungsmöglichkeit, um die Erkrankung deutlich zu verlangsamen oder zu stoppen. Bereits Jahrzehnte vor Diagnosestellung der AD beginnen die pathologischen Mechanismen. Aktuelle Behandlungsmethoden setzen jedoch häufig erst nach Diagnosestellung einer AD an, also zu einem Zeitpunkt, an dem das Gehirn schon eine deutliche Neurodegeneration aufweist. Die Untersuchung von Risikogruppen zur Identifikation von frühen Biomarkern und nebenwirkungsarmen Behandlungsmethoden bietet ein großes Potential, um die Erkrankung möglichst früh entdecken und verlangsamen oder vielleicht sogar stoppen zu können. Risikogruppen im späteren Lebensabschnitt sind beispielsweise Träger des genetischen Hauptrisikofaktors Apolipoprotein-E4 (APOE4), Patienten mit einer subjektiven kognitiven Beeinträchtigung sowie Patienten mit einer objektiven leichten kognitiven Beeinträchtigung (engl. mild cognitive impairment; MCI).
Die Untersuchung der hämodynamischen Reaktion mittels funktioneller Nahinfrarotspektroskopie (fNIRS) ist aufgrund der einfachen und kostengünstigen Einsetzbarkeit dieser Methodik besonders praktikabel. Auch der wiederholte Befund einer reduzierten hämodynamischen Reaktion bei Patienten mit AD scheint vielversprechend. Untersuchungen mit AD-Risikogruppen gibt es bisher jedoch nur wenige; zudem weisen diese uneindeutige Befunde auf.
Ziel der vorliegenden Arbeit ist daher die Untersuchung der hämodynamischen Reaktion bei den Risikogruppen ‚APOE4‘ und ‚MCI‘ im Vergleich zu gesunden Kontrollen während Wortflüssigkeitsaufgaben, die mittels fNIRS bereits gut etablierte Aufgaben darstellen. Des Weiteren wird in der vorliegenden Arbeit die Wirkung einer nebenwirkungsarmen Behandlungsmethode im Vergleich zu einer sham-Behandlung bei der Risikogruppe ‚subjektive kognitive Beeinträchtigung‘ untersucht. Bei dieser Behandlungsmethode handelt es sich um ein mittels transkranieller Gleichstromstimulation (engl. transcranial direct current stimulation; tDCS) augmentiertes kognitives Training.
Es zeigt sich für die Risikogruppe APOE4 bei gleicher Leistung im Vergleich zu Trägern anderer Allelvarianten eine verminderte hämodynamische Reaktion im typischerweise aufgabenspezifisch genutzten inferioren frontalen Gyrus. Parallel dazu weist der mediale frontale Gyrus, ein Teil des frontoparietalen Kontrollsystems, eine verstärkte hämodynamische Reaktion auf. Bei der Risikogruppe MCI zeigt sich neben einer schlechteren Testleistung eine verminderte hämodynamische Reaktion des infe-rioren frontotemporalen Kortex, welcher den inferioren frontalen Gyrus umfasst. Das tDCS-augmentierte kognitive Training bewirkt nicht nur einen gruppenunspezifischen Anstieg der hämodynamischen Reaktion im inferioren frontotemporalen Kortex, die tDCS verstärkt diesen Effekt im Vergleich zur sham-Stimulation noch zusätzlich. Dies geht jedoch nicht mit einer Veränderung der Testleistung einher.
Insgesamt deuten die Ergebnisse darauf hin, dass eine reduzierte hämodyna-mische Reaktion bereits in frühen Krankheitsstadien der AD detektierbar ist und dies möglicherweise als Biomarker für eine frühzeitige Detektion und Behandlung genutzt werden könnte. Des Weiteren bietet die tDCS für frühe Krankheitsstadien der AD das Potential einer nebenwirkungsarmen Behandlungsmethode.
Alzheimer’s disease (AD) is the most common form of dementia, and currently, there is no treatment to cure or halt disease progression. Because the one-target strategy focusing on amyloid-β has failed to generate successful pharmaceutical treatment, this work studies natural products with pleiotropic effects focusing on oxidative stress and neuroinflammation as key drivers of disease progression. The central part of this work focused on flavonoids as neuroprotectants. 7-O-Esters of taxifolin and cinnamic or ferulic acid were synthesized and investigated towards their neuroprotective potential addressing aging and disease. 7-O-Feruloyl- and 7-O-cinnamoyltaxifolin showed overadditive effects in oxidative stress-induced assays in the mouse neuronal cell line HT22 and proved to be protective against neuroinflammation in microglial BV-2 cells. The overadditive effect translated to animals using an Aβ25-35-induced memory-impaired AD mouse model where the compounds were able to ameliorate short-term memory defects. While the disease-modifying effects in vivo were observed, the detailed mechanisms of action and intracellular targets of the compounds remained unclear. Hence, a chemical probe of the neuroprotective flavonoid ester 7-O-cinnamoyltaxifolin was developed and applied in an activity-based protein profiling approach. SERCA and ANT-1 were identified as potential targets. Further, chemical modifications on the flavonoids taxifolin, quercetin, and fisetin were performed. The achievements of this work are an important contribution to the use of secondary plant metabolites as neuroprotectants. Chemical modifications increased the neuroprotective effect of the natural products, and distinct intracellular pathways involved in the neuroprotective mechanisms were identified. The results of this work support the use of secondary plant metabolites as potential therapeutics and hint towards new pharmacological targets for the treatment of neurodegenerative disorders.
Alzheimer´s disease (AD) is a neurodegenerative disease and the most common form of dementia with still no preventive or curative treatment. Besides several risk factors, age is one of the major risks for AD and with an aging society, there is an urgent need for disease modifying agents. The strategy to address only one target within the intertwined network of AD failed so far.
Natural products especially the phytochemical flavonoids, which are poly-phenolic natural products, have shown great potential as disease modifying agents against neurodegenerative disorders like Alzheimer´s disease (AD) with activities even in vivo. Flavonoids are produced by many plants and the native Californian plant Eriodictyon californicum is particularly rich in flavonoids. One of the major flavonoids of E. californicum is sterubin, a very potent agent against oxidative stress and inflammation, two hallmarks and drivers of AD and neurodegeneration. Herein, racemic sterubin was synthesized and separated into its pure (R)- and (S)-enantiomer by chiral HPLC. The pure enantiomers showed comparable neuroprotection in vitro with no significant differences. The stereoisomers were configurationally stable in methanol, but fast racemization was observed in culture medium. Moreover, the activity of sterubin was investigated in vivo, in an AD mouse model. Sterubin showed a significant positive impact on short- and long-term memory at low dosages.
A promising concept for the increase of activity of single flavonoids is hybridization with aromatic acids like cinnamic or ferulic acids. Hybridization of the natural products taxifolin and silibinin with cinnamic acid led to an overadditive effect of these compounds in phenotypic screening assays related to neurodegeneration and AD. Because there are more potent agents as taxifolin or silibinin, the hybrids were further developed, and different flavonoid cinnamic acid hybrids were synthesized. The connection between flavonoids and cinnamic acid was achieved by an amide instead of a labile ester to improve the stability towards hydrolysis to gain better “druggability” of the compounds. To investigate the oxidation state of the C-ring of the flavonoid part, the dehydro analogues of the respective hybrids were also synthesized. The compounds show neuroprotection against oxytosis, ferroptosis and ATP-depletion in the murine hippocampal cell line HT22. While no overall trend within the flavanones compared to the flavones could be assigned, the taxifolin and the quercetin derivative were the most active compounds in course of all assays. The quercetin derivate even shows greater activity than the taxifolin derivate in every assay. As desired no hydrolysis product was found in cellular uptake experiments after 4h, whereas different metabolites were found. The last part of this work focused on synthetic bioisoteres of the natural product curcumin. Due to the drawbacks of curcumin and flavonoids arising from poor pharmacokinetics, rapid metabolism and sometimes instability in aqueous medium, we have examined the biological activity of azobenzene compounds designed as bioisoteres of curcumin, carrying the pharmacophoric catechol group of flavonoids. These bioisosteres exceeded their parent compounds in counteracting intracellular oxidative stress, neuroinflammation and amyloid-beta aggregation. By incorporating an azobenzene moiety and the isosteric behaviour to the natural parent compounds, these compounds may act as molecular tools for further investigation towards the molecular mode of action of natural products.
The research that is compiled in this thesis can be divided in two parts. The first part, consisting of four chapters, is centered around the role of epigenetic dysregulation in the etiopathophysiology of sporadic alzheimer's disease (sAD). In addition to providing insights into the most recent developments in neuroepigenomic studies of this disease, the first part of the thesis also touches upon remaining challenges, and provides a future outlook on possible developments in the field. The second part, which includes three more chapters, is focused on the application of induced pluripotent stem cell (iPSC)-based disease models for the study of AD, including but not limited to mechanistic studies on epigenetic dysregulation using this platform. Aside from outlining the research that has been conducted using iPSC-based models for sAD to date, the second part of the thesis also provides insights into the acquisition of disease-relevant neural cultures based on directed differentiation of iPSCs, and furthermore includes an experimental approach for the establishment of such a model system.
Drug Discovery based on Oxidative Stress and HDAC6 for Treatment of Neurodegenerative Diseases
(2024)
Most antioxidants reported so far only achieved limited success in AD clinical trials. Growing evidences suggest that merely targeting oxidative stress will not be sufficient to fight AD. While multi-target directed ligands could synergistically modulate different steps in the neurodegenerative process, offering a promising potential for treatment of this complex disease.
Fifteen target compounds have been designed by merging melatonin and ferulic acid into the cap group of a tertiary amide HDAC6 inhibitor. Compound 10b was screened as the best hybrid molecule exhibit potent HDAC6 inhibition and potent antioxidant capacity. Compound 10b also alleviated LPS-induced microglia inflammation and led to a switch from neurotoxic M1 to the neuroprotective M2 microglial phenotype. Moreover, compound 10b show pronounced attenuation of spatial working memory and long-term memory damage in an in vivo AD mouse model. Compound 10b can be a potentially effective drug candidate for treatment of AD and its druggability worth to be further studied.
We have designed ten novel neuroprotectants by hybridizing with several common antioxidants, including ferulic acid, melatonin, lipoic acid, and trolox. The trolox hybrid compound exhibited the most potent neuroprotective effects in multiple neuroprotection assays. Besides, we identified the synergistic effects between trolox and vitamin K derivative, and our trolox hybrid compound showed comparable neuroprotection with the mixture of trolox and vitamin K derivative.
We have designed and synthesized 24 quinone derivatives based on five kinds of different quinones including ubiquinone, 2,3,5-trimethyl-1,4-benzoquinone, memoquin, thymoquinone, and anthraquinone. Trimethylbenzoquinone and thymoquinone derivatives showed more potent neuroprotection than other quinones in oxytosis assay. Therefore, trimethylbenzoquinone and thymoquinone derivatives can be used as lead compounds for further mechanism study and drug discovery for treatment of neurodegenerative disease.
We designed a series of photoswitchable HDAC inhibitors, which could be effective molecular tools due to the high spatial and temporal resolution. In total 23 target compounds were synthesized and photophysicochemically characterized. Azoquinoline-based compounds possess more thermally stable cis-isomers in buffer solution, which were further tested in enzyme-based HDAC inhibition assay. However, none of those tested compounds show significant differences in activities between trans-isomers and corresponding cis-isomers.